Effects of body mass index (BMI) on surgical outcomes: a nationwide survey using a Japanese web-based database

Motonari Ri, Hiroaki Miyata, Susumu Aikou, Yasuyuki Seto, Kohei Akazawa, Masahiro Takeuchi, Yoshiro Matsui, Hiroyuki Konno, Mitsukazu Gotoh, Masaki Mori, Noboru Motomura, Shinichi Takamoto, Yoshiki Sawa, Hiroyuki Kuwano, Norihiro Kokudo

Research output: Contribution to journalArticlepeer-review

47 Citations (Scopus)


Purpose: To define the effects of body mass index (BMI) on operative outcomes for both gastroenterological and cardiovascular surgery, using the National Clinical Database (NCD) of the Japanese nationwide web-based database. Methods: The subjects of this study were 288,418 patients who underwent typical surgical procedures between January 2011 and December 2012. There were eight gastroenterological procedures, including esophagectomy, distal gastrectomy, total gastrectomy, right hemicolectomy, low anterior resection, hepatectomy of >1 segment excluding the lateral segment, pancreaticoduodenectomy, and surgery for acute diffuse peritonitis (n = 232,199); and five cardiovascular procedures, including aortic valve replacement, total arch replacement (TAR), descending thoracic aorta replacement (descending TAR), and on- or off-pump coronary artery bypass grafting (n = 56,219). The relationships of BMI with operation time and operative mortality for each procedure were investigated, using the NCD. Results: Operation times were longer for patients with a higher BMI. When a BMI cut-off of 30 was used, the operation time for obese patients was significantly longer than that for non-obese patients, for all procedures except esophagectomy (P < 0.01). The mortality rate based on BMI revealed a U-shaped distribution, with both underweight and obese patients having high mortality rates for almost all procedures. Conclusions: This Japanese nationwide study provides solid evidence to reinforce that both obesity and excessively low weight are factors that impact operative outcomes significantly.

Original languageEnglish
Pages (from-to)1271-1279
Number of pages9
JournalSurgery today
Issue number10
Publication statusPublished - Oct 14 2015
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery


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